Provider Demographics
NPI:1508059627
Name:EYE CARE WEST, P.C.
Entity Type:Organization
Organization Name:EYE CARE WEST, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:269-651-7874
Mailing Address - Street 1:26289 W CHICAGO RD
Mailing Address - Street 2:P O BOX 128
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-8706
Mailing Address - Country:US
Mailing Address - Phone:269-651-7874
Mailing Address - Fax:269-651-4154
Practice Address - Street 1:26289 W CHICAGO RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-8706
Practice Address - Country:US
Practice Address - Phone:269-651-7874
Practice Address - Fax:269-651-4154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002336152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI900G510330OtherBCBSM
MIU76589Medicare UPIN
MI900G510330OtherBCBSM
MIU54181Medicare UPIN
MI5646460001Medicare NSC